"Now is the winter of our discontent..."

So, how can you avoid a winter of discontent and enter 2024 headed for a glorious spring, summer, and fall? Shakespeare penned an impressive 38 plays and there are nearly as many ways I can suggest to achieve this goal.

Food: “They call for dates and quinces in the pastry” (Romeo & Juliet).

1. First appearing in Henry IV (parts I and II) and a recurring character in Shakespeare’s plays, Sir John Falstaff is portrayed as fat. Until recently, famine-induced starvation was our major food-related illness. While sadly there are many who go to sleep hungry, overeating has replaced starvation. Over 2/3 of Americans are overweight or obese, causing illness and tragic early death as in so many Shakespearean plays. Charmian, an attendant in Antony & Cleopatra, says “I love long life better than figs!” Eat less, live longer!
2. I continue to wax, hopefully lyrically, about the benefits of a well-balanced diet, consuming natural foods wrapped by nature rather than tins, plastic, and cardboard. Bill nailed it in Troilus and Cressida: “One touch of nature makes the whole world kin!”
3. Like Proteus penning countless love letters in Two Gentlemen of Verona, my AOPA writings have advised with food supplements. Medical science demands keeping an open, but skeptical, mind. Vitamin C has been proposed as a cure for common colds. Data shows it does not prevent colds, or cure colds, but might shorten symptoms. A recent scientific paper evaluating 11,000 people established that treating vitamin D deficiency (dairy-poor diet, darker skin, and/or living in low sunlight climates) effectively prevents infectious respiratory diseases; have your vitamin D levels checked, and if low, consider dietary changes or supplements. Zinc lozenges may possibly reduce cold symptoms duration, but upset stomach may be an issue for some. Zinc is found in oysters, chocolate, red meat, poultry, dairy, nuts, and cereals, so consider reviewing your diet.
4. In The Taming of the Shrew, Katherina and Petruchio conduct a double-entendre-rich argument:

Katherina: I knew you at the first, you were a movable.

Petruchio: Why, what’s a movable?

Katherina: A joint stool.

While suggesting bar furniture (French meuble) this means a pile of feces with a nice twirl, suggesting a high-fiber diet! Conversely, low-fiber diets cause colorectal cancer, diabetes, stroke and heart disease, and others. So, review your fiber intake, and if the only twisted stool you see is in your favorite tavern, All’s Well that Ends Well will not apply to you!

Drink: “I pray you, do not fall in love with me, For I am falser than vows made in wine” (As You Like It).

1. In Henry VIII, Griffith states, “Men’s evil manners live in brass; their virtues we write in water.” We easily recall evil done to us, but forget the good. Humans are 55–60% water and should drink eight glasses a day to protect from kidney disease, gastrointestinal problems, and prevent overeating. With a safe water supply, bottled water is unnecessary.

    

2. Shakespeare often referenced alcohol: “O God, that men should put an enemy in their mouths to steal away their brains!” (Othello). Or “It provokes desire but takes away the performance” and “What three things does drink especially provoke? Porter: Marry, sir, nose-painting, sleep, and urine” (Macbeth); the “nose-painting” refers to an alcoholic’s red nose. Alcohol causes multiple diseases; consider intake and frequency and if too high, please seek help.

    

3. From Henry V: “One poor penny worth of sugar-candy,” but caffeine consumption in coffee, tea, and chocolate was not common until after his death in 1616. And it should be for you too—after 16:16 hours local, not Zulu, avoid caffeine if you want to enter the Land of Nod, although some would say 14:00 is a better time.
4. “Double, double toil and trouble; Fire burn and cauldron bubble. Cool it with a baboon’s blood, Then the charm is firm and good” (Macbeth). While these bubbles are from fire, the foul ingredients could equally refer to carbonated beverages. Packed with sugar and gas, they aren’t good for us, inducing ailments like obesity (super-sized sodas contain 1/3 of daily male caloric intake), dental caries, and heart disease. Additionally, imbibed gas has to find a way out with pressure changes associated with ascending to great heights; who wants to share a cockpit with gut-processed soda gas?

Actions to take: “Action is eloquence” (Coriolanus).

1. Would you take action to avoid diarrheal disease by 40%, communicable illness by 80%, and substantially reduce colds, flus, and pneumonia? Those who hand wash have 24% fewer respiratory sick days and 51% fewer GI problems.

    

   Every hour we touch about 1.5 million germs and once on your hands they grow like germs! Flushing an open-lid toilet releases a fecal germ plume onto your clothes, the air you breathe, your phone, everywhere. Ever seen someone leave a restroom without washing their hands? On average, 75% of women and 50% of men wash their hands after using the toilet, 20% of people don’t wash routinely, and 30% don’t use soap. Damp hands are one thousand times more likely to disseminate bacteria, yet only 20% of those who wash bother to dry their hands. Pressing elevator buttons, handling a banknote or credit card machine, you are literally touching somebody else’s feces!

   
   Wash hands regularly for 20 seconds with soapy hot water and dry thoroughly, at the very least after using bathrooms, and before and after meals and physical contact with people or items.

   Shakespeare nailed it in Timon of Athens: “Would thou wert clean enough to spit upon”—you are so dirty I would not sully my spit upon you!

2. Speaking of insults, my last vaccination discussion provoked some rather interesting language! Shakespeare had a delicious turn of phrase—these few examples were rather more tasteful versions of the vitriol directed at me:

   “The rankest compound of villainous smell that ever offended nostril” (The Merry Wives of Windsor).

   “Thou art unfit for any place but hell” (Richard III).

   “Thou hast no more brain than I have in mine elbows” (Troilus and Cressida).

   “You bull’s pizzle” (Henry IV Part I).

   But I care about my readers, shall ignore past ignominies, and suggest folks consider getting annual flu shots, shingles, pneumonia, or other recommended vaccine(s). Should you wish to insult my suggestions, please come up with something inspired!

3. Britain’s greatest playwright references sleep often; whether Hamlet’s “to sleep” soliloquy or the mischievous fun of A Midsummer Night’s Dream. Sound sleep provides good health and life span and supports your immune system, thereby avoiding winter ills. Sleep is assisted by good diet, regular exercise and bedtime, a dark, cool, quiet bedroom, avoiding electronics and other stimuli, and limiting alcohol and caffeine intake.
4. Meaningful, regular exercise regularly improves general health and enhances the immune system in several ways. I discussed these health benefits in prior articles (https://www.aopa.org/news-and-media/all-news/2016/october/pilot/fly-well-medical-reform) and as per the Blue Zones observations, it does not require gym membership!
5. Viruses causing colds, flu, and winter vomiting favor dry air, so consider humidifying your home. Going out in the cold does not cause colds, but chilly, dry air desiccates airways, enabling viruses to enter. If one has a preexisting condition like asthma, such risks are increased.
6. During Covid, people were constantly advised to wear masks, probably not germane nowadays. However, wrapping a scarf over nose and mouth outdoors keeps airways warm and moist and is a barrier to other people’s bugs, and on crowded trains, it might be wise to cover up in this manner.
7. Avoiding stress helps to avoid illness; when anxious the body cannot efficiently fight infections. Take time to relax, practice mindfulness, and do exercise or yoga to help protect yourself from illness. “A turn or two I’ll walk, To still my beating mind” (The Tempest).
8. Winter is a good time to discard old medicines. Also, ask your doctor if any current drugs can be terminated or adjusted, and check AOPA’s Medication database (https://www.aopa.org/go-fly/medical-resources/medications-database) to confirm all are compatible with legal flight. This will help avoid the “Comedy of Errors” that might otherwise ensue due to medication problems.

 ACTIONS TO AVOID: "IGNORANCE IS THE CURSE OF GOD; KNOWLEDGE IS THE WING WHEREWITH WE FLY TO HEAVEN" (Henry VI).

1. Are we heroes, battling illness, going to work or social events while unwell? Or tragic heroes? Gifts are usually welcome but nobody will thank you for a viral illness gift! Before hosting gatherings or meetings, remind people to stay away if sick. If you doubt this makes sense, think of cruise ship passengers afflicted with norovirus!
2. Winter weather drives many to seek the sun; others head to the ski slopes. Large airport crowds and crowded planes are perfect petri dishes for infectious disease season. We are blessed; a real benefit of GA is avoidance of the great unwashed and virus-ridden! Remember to advise anyone joining you on a winter trip to abort if unwell—one sneeze in a small cockpit and all are infected!
3. A colleague of mine years ago told me he had not developed a cold or flu in many years and he maintained it was because he never touched his face. It is sound advice and a discipline many learned during the pandemic. Data supports that touching one’s face is a habit worth eradicating.
4. Take time to revisit how you prepare and store food; inclement weather is a disincentive to more frequent food shopping, and consumption of perishables past their best is risky.
5. Dark winter days make depression more likely. Be aware of this in yourself and others and if signs are present, seek help. While suicide rates are lowest in winter, other effects of seasonal affective disorder (SAD) may become apparent.

through William Shakespeare and can avoid the ills of winter. All that remains is to wish you a happy new year, and as Bill would say:

“Parting is such sweet sorrow, That I shall say good night till it be morrow.”

Fly well!

You can send your questions and comments to Dr. Sackier via email: [email protected] and listen to his weekly podcasts at:

https://www.emg-health.com/omnipresent/?category=podcasts&therapeutic_area=healthcare